1998
DOI: 10.1007/bf02744936
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The need to step up the gonadotropin dosage in the stimulation phase of IVF treatment predicts a poor outcome

Abstract: Purpose: It is a common practice to increase the gonadotropin dose during ovarian stimulation when the estradiol (E2)rise

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Cited by 14 publications
(9 citation statements)
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“…We show that prolonged stimulation imposes a detrimental prognostic effect that is independent of other influences. It should be stressed that our study agrees with the extant literature in that higher gonadotropin requirements correlate with reduced clinical pregnancy and live birth after ART [11,[19][20][21]. Additionally, it is possible that duration of gonadotropin stimulation during ART may not be an easily modifiable factor: once a controlled ovarian hyperstimulation cycle has been initiated, it may be too late to modify treatment in order to positively affect the outcome.…”
Section: Discussionsupporting
confidence: 75%
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“…We show that prolonged stimulation imposes a detrimental prognostic effect that is independent of other influences. It should be stressed that our study agrees with the extant literature in that higher gonadotropin requirements correlate with reduced clinical pregnancy and live birth after ART [11,[19][20][21]. Additionally, it is possible that duration of gonadotropin stimulation during ART may not be an easily modifiable factor: once a controlled ovarian hyperstimulation cycle has been initiated, it may be too late to modify treatment in order to positively affect the outcome.…”
Section: Discussionsupporting
confidence: 75%
“…Our data contribute to the consensus in the literature suggesting detrimental prognostic impact of increased gonadotropin requirements during ART [11,[19][20][21]. While most studies of gonadotropin utilization focus on the total amount of medication administered per cycle, we specifically evaluated live birth outcomes in relation to the time needed to achieve follicular development appropriate for oocyte retrieval.…”
Section: Discussionmentioning
confidence: 76%
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“…Although our findings are in concert with the published literature, we extend the previously reported observations of the total number of oocytes retrieved to the concept of mature oocyte yield. This provides an additional dimension to the argument that more is not always better, especially when it comes to standard ART cycle parameters, including the total amount of gonadotropins used per cycle (9)(10)(11). Biological plausibility for the lack of benefit with higher oocyte yield includes potential detrimental effects of higher levels of sex steroids on oocyte quality.…”
Section: Discussionmentioning
confidence: 97%
“…The RCT clearly demonstrated that doubling the human menopausal gonadotrophin (hMG) dose in patients with a low response after 5 days of 225 IU hMG, did not result in a higher number of oocytes retrieved compared to patients treated with a fixed dose [22]. The two retrospective studies also concluded that a low response after 5 days of hMG therapy may not be averted by doubling or increasing the dose of hMG [23,24].…”
Section: Increasing the Dose During The Course Of An Ivf Cyclementioning
confidence: 99%